Acne is a common human skin disease. It can be defined as the chronic inflammatory disorder of pilo sebaceous follicles. It may be characterized by inflammatory or non inflammatory papules, pustules, nodules in its more severe form or scars. The lesions of acne are commonly called pimples, blemishes, spots etc. It occurs mostly in the areas of skin where sebaceous follicles are dense. Areas mostly affected by acne are forehead, cheeks, chin, upper arms and upper trunk. Course of the disorder varies extremely ranging from months to years.
There are certain well recognized forms of acne:
1. Acne vulgaris: It is the most common type of acne observed in teenagers.
2. Acne excorie: Squeezing of acne lesions result in scarring and disfiguration
3. Acne neonatorum: It is also known as juvenile acne. It is a manifest of a virilizing syndrome and is usually seen during first two years of life. But in most of the cases cause remains unknown
4. Acne conglobata: This kind of acne is mostly encountered in males characterized by chronic burrowing and scarring
5. Acne venenata: Chemical exposure e.g. tars; mineral oil etc is the cause
Acne most commonly occurs in adolescents. It affects more than 90-96% teenagers and may also continue in adulthood. The processes causing acne are similar for skin of all colors. But the darker skin has more effects of acne. It diminishes and tends to disappear over time; however no one can predict how long it will take to disappear entirely. Besides scarring, acne can affect a patient psychologically. It can result in lack of self confidence, depression and social insecurity.
Acne occurs due to blocked follicles which may be due to the hyperkeratinization and keratin or sebum plug formation. Sebaceous glands when become clogged with sebum directly results in whiteheads or closed comedone. Naturally occurring bacteria Propionibacterium acnes cause inflammation by producing lipase, splitting the fats into fatty acids and triglycerides which are comedogenic and lead to papules, pustules, or nodules formation in the skin around comedone resulting in redness, scarring or hyperpigmentation.
Primary causes of acne may include family or genetic history, hormonal activity (menstruation and puberty), and stress which may result in increased acne severity. Diet factors may include consumption of chocolate, milk, low levels of vitamin A and E. High humidity and temperature may induce severe relapse.
Acne should not be taken lightly as it can cause considerable psychological and physical trauma. General treatment of acne includes elimination of acneigenic drugs and chemicals, avoiding chocolates and nuts in susceptible patients. Also avoid greasy cosmetics as they are another reason for acne.
Topical as well as systemic treatment may also be given during acne. Tetracyclines, erythromycin, antiandrogens, retinoids are given to treat acne systemically. Whereas in case of topical treatments it is advised to wash the affected area three to four times a day with soap and water. Keratolytic agents such as salicylic acid or sulphur in the form of lotion or cream are given and applied to induce exfoliation. Erythromycin and tetracycline are also available as topical lotions and creams.
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